Margin Machine

Surgical Margins Impact Patient Follow Up & Wait Times

Worldwide more than 10 million people are diagnosed with cancer and more than 6.5 million die from cancer each year. An estimated 171,000 new cases of cancer were diagnosed (excluding non-melanoma skin cancer) and 75,300 deaths from cancer occurred in 2007 (Canadian Cancer Statistics 2009). Lung cancer is the leading cause of cancer death accounting for 28.3% for men and 26.3% for women of all the cancer deaths. Breast cancer continues to lead incidence with over 10000 new cases in Canada in 2009.

The high rate of cancer incidence and resulting deaths indicate a need for high accuracy and speed in diagnosis as well as maximum efficiency in treatment to improve patient outcomes.

These statistics highlight the need for a rapid, accurate diagnostic tool that can differentiate benign from malignant tissue in targeted cancers i.e. breast, lung and liver. Such a tool would have applications in the diagnostic phase of certain cancers and in the operating room, to provide efficient, accurate and costeffective diagnostic precision to improve patient outcomes, quality of life, as well as minimizing the cost of this disease to health care providers.

This research will help in the development of a system that will provide immediate intraoperative margin assessment. The aim is to have an intra-operative decision support system for use by surgeons to provide information on tissue type in order to optimize tumour removal and preserve healthy tissue. The higher confidence in accurate and complete tumour removal at a single surgical procedure will result in reduced patient anxiety and facilitate rapid surgical management and post-operative adjuvant therapies. It should also lead to greater efficiency in the use of surgeon and hospital resources.

The research will also be of potential use to facilitate rapid and accurate initial outpatient assessment of cancer versus benign tissue. As an example one of the most difficult aspects of breast assessment is the time interval between clinical or radiological identification of an abnormality and histological confirmation of tissue as benign or malignant. This delay can be significant, causing undue stress for women awaiting diagnosis, and delaying definitive care.

A diagnostic tool that provides immediate confirmation at an outpatient breast assessment centre will speed up the decision-making and treatment process to potentially improve quality of life for patients as well as reducing costs and time to treatment.

This is a truly collaborative project, which brings together health science i.e. the clinical oncologist and the cancer surgeon and experts from the field of radiation physics applied to medicine.